Healthcare Provider Details
I. General information
NPI: 1356734081
Provider Name (Legal Business Name): MELISSA DAWN GASPAR APRN, CNM, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/04/2015
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1411 BRADLEY AVE
BEAUMONT MS
39423-5611
US
IV. Provider business mailing address
PO BOX 1729
HATTIESBURG MS
39403-1729
US
V. Phone/Fax
- Phone: 601-784-3922
- Fax:
- Phone: 601-545-8700
- Fax: 601-255-2645
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 906642 |
| License Number State | MS |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | NUR-APRN-LIC-100052 |
| License Number State | MT |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | NUR-APRN-LIC-100052 |
| License Number State | MT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: